itchy scalp & rash

my 7yro daughter started having an itchy scalp w/ a rash behind her ears & on the back of her neck. This has been going on for 3 days; we recently changed shampoos and we believe that this may be the problem. I have been bathing her in baking soda baths & baby shampoo w/ multiple rinsing, 12.5mg of Benadryl PRN and Hydrocortizone Creme @ hs & in the a.m.
The rash has lessened, but, still itching & the rash is milder, but, still there.

Thanks,
Tonya Sheats, Georgia


This discussion is related to Itching, rash on scalp and neck.

[Vanessa Lacuesta]

Hi,

Has she been assessed by a physician ?

Was she given a diagnosis for her rash?

One differential for this is seborrheic dermatitis. Seborrheic dermatitis appears as a greasy rash over the scalp ,face and neck.There may be some flaking involved. Does your daughter have any of these? Seborrheic dermatitis usually involves the scalp in children and may affect even children of the younger age group.

Other differentials will be a fungal infection, an allergic reaction and psoriasis.With these as differentials , it is best to have your child assessed by pediatric dermatologist. Most of these skin conditions respond to a corticosteroid. In the case of a seborrheic dermatitis , corticosteroids may only be used in more severe cases.

Here is something to guide you by in seborrheic dermatitis cases for children with scalp lesions:

Source: http://www.drmhijazy.com/english/chapters/chapter27.htm

Scalp lesions of seborrheic dermatitis :
• Mild cases: may need simply a mild shampoo (Head & Shoulder shampoo, Zincon shampoo) used every other day .
• Moderate cases : Hydrocortisone lotion ( Lococorten lotion ) , locoid scalp, elocom lotion with a mild shampoo .
• Severe cases: Fluorinated corticosteroid lotions may be needed for chronic recurrent , reluctant cases and a shampoo containing tar (Poly tar shampoo , Zeton shampoo) .
• Seborrheic dermatitis of the eyelids : Mild shampoo such as baby shampoo used several times and applying hydrocortisone ophthalmic ointment twice daily for a short period .
• Nizoral shampoo can be used for older children and adults for a short period can give good results . Selenium sulfide shampoo (Selsun ) is an effective in seborrheic dermatitis. Long use of such shampoos may cause hair falling. Care for the eyes during washing of the scalp, because these may cause irritation.
• Seborrheic dermatitis of the scalp is usually complicated by secondary bacterial infections such as folliculitis. Antibacterial lotion such as Erythrocin (Eryderm lotion) or clindamycin (Dalacin T lotion) can be applied twice daily to the scalp.
• Bacterial infections of the scalp should be treated before application of corticosteroids lotions, where the latter are postponed till controlling the bacterial infections. Oral antibiotics such as cephalosporins, Erythrocin, Zithromax may be indicated in severe extensive infections. Doxacyclines, Minocycline and Tetracyclines are not given for children but they have good effect in adults.

Inform your physician before using any medications on the area so you may be guided accordingly.Do not use or apply anything unless the diagnosis of seborrheic dermatitis has been ascertained and your child has been evaluated by your physician.